NPRC Peer Mentor Survey

National Paralysis Resource Center (NPRC) Performance Management Support Evaluation

NPRC Ins 5 Peer Mentor Survey

OMB: 0985-0077

Document [pdf]
Download: pdf | pdf
RTI International
NPRC Outcomes Evaluation
Peer Mentor Survey1
Section 1. Introduction
The Administration for Community Living (ACL) has contracted with RTI International for an evaluation of the
National Paralysis Resource Center (NPRC), which is implemented by the Reeve Foundation. The purpose of this
evaluation is to learn more about the Reeve Foundation’s programs and what lessons can be learned to inform
other ACL programs.
As part of this evaluation, RTI needs your help. You have been specially selected to participate in this survey of
peer mentors serving their community through the Reeve Foundation’s programs. Your participation in this survey
will ensure that the evaluation captures the full range of mentors’ experiences and outcomes.

Section 2. Mentoring experience
(Required) Q1. Are you currently volunteering as a mentor through the Reeve Foundation?
a. Yes
b. No [PROGRAMMER: GO TO END1]
(Required) Q2. Which of the following choices best described you when you volunteered to be a peer mentor?
a. Someone living with paralysis
b. Caregiver to someone living with paralysis
Q3. Approximately when did you mentor the first peer assigned to you?
a. 6 months or less
b. More than 6 months but less than 1 year ago
c. 1–2 years ago
d. More than 2 years ago
e. I have not mentored a peer yet [PROGRAMMER: GO TO Q10]
Q4. Including the first peer, about how many peers have you mentored?
a. 1–2 peers
b. 3–5 peers
c. 6–10 peers
d. More than 10 peers
Q5. Thinking about your experience as a mentor, how common is it that a peer has only one or two interactions
with you? Interactions can be an exchange of emails, a phone call, a video call, or an in-person meeting.
a. Uncommon (few)
b. Neither common or uncommon (about half)
c. Common (most)
Q6. Thinking about the peer that you have mentored the longest, about how many months have you been in
contact with that peer?
a. Less than 3 months
b. 3–6 months
c. More than 6 months but less than 1 year ago
d. 1–3 years
e. More than 3 years
98. Don’t know [only added after a soft prompt]

1

Unless flagged, questions are not required and will only get a soft prompt encouraging them to answer to the
best of their ability.

1

Q7. Since March 2020, how do you communicate most often with your peer mentees? Please consider all types of
communication including checking in on them and meetings.
a. In face-to-face meetings
b. By telephone
c. Using video conferencing
d. By email
e. By chat or text messaging
f. Other (Specify)
Q8. Thinking about the peer with whom you communicate with most frequently, about how frequent are your
communications?
a. Every day
b. A few times per week
c. A few times per month
d. A few times per year
Q9. During the last month, about how many peers did you communicate with?
[PROGRAMMER: NUMERIC ENTRY]

Section 3. Mentoring resources
Q10. Below are characteristics used to match mentors to peers. With 1 being most important and 9 being least,
rank the following in order of importance to you in matching mentors to peers.
[PROGRAMMER: USE RANKING FEATURE FOR RESPONSE OPTIONS]
a. Age
b. Gender identity
c. Sexual orientation
d. Cause of paralysis
e. Level of injury
f. Race
g. Ethnicity
h. Veteran status
i. Interests
j. Where you live
k. Time since paralysis
[ASK IF Q3=a, b, c, or d] Q11. Thinking across all of your mentor-peer relationships, how would you rate the overall
quality of the mentor-peer match?
a. Poor
b. Fair
c. Good
d. Very good
e. Excellent
[ASK IF Q3=a, b, c, or d] Q12. Thinking across all your mentor-peer relationships, how would you rate the Reeve
Foundation´s approach to resolving issues in case of a poor match between you and your peer?
a. Poor
b. Fair
c. Good
d. Very good
e. Excellent
f. Does not apply
Q13. How helpful to you was the initial certification training from the Reeve Foundation in helping you meet peer
needs?
a. I have never attended the initial certification training.

2

b.
c.
d.
e.
f.

Not at all helpful
Slightly helpful
Somewhat helpful
Moderately helpful
Extremely helpful

Q14. How helpful to you were the occasional webinar-based trainings from the Reeve Foundation in helping you
meet peer needs?
a. I have never attended webinar-based trainings.
b. Not at all helpful
c. Slightly helpful
d. Somewhat helpful
e. Moderately helpful
f. Extremely helpful
Q15. How helpful to you were the written resources from the Reeve Foundation in helping you meet peer needs?
a. I have never used the written resources.
b. Not at all helpful
c. Slightly helpful
d. Somewhat helpful
e. Moderately helpful
f. Extremely helpful
Q16. How helpful to you was the Reeve Foundation´s Facebook group for mentors in helping you meet peer
needs?
a. I have never used the Facebook group.
b. Not at all helpful
c. Slightly helpful
d. Somewhat helpful
e. Moderately helpful
f. Extremely helpful
Q17. How helpful was talking directly to Reeve Foundation staff for you in meeting peer needs?
a. I have never talked with Reeve Foundation staff about peer mentor needs.
b. Not at all helpful
c. Slightly helpful
d. Somewhat helpful
e. Moderately helpful
f. Extremely helpful
Q18. Which resource from the Reeve Foundation is most helpful in supporting you to be a peer mentor?
[PROGRAMMER: USE SKIP LOGIC TO REMOVE RESOURCES FROM THE OPTIONS THEY NEVER USED IN Q13 TO Q17]
a. Initial certification training
b. Occasional webinar-based trainings
c. Written resources
d. Facebook group for mentors
e. Reeve Foundation staff
f. Other (Specify)
Q19. Within the Reeve Foundation resources, which topic has been most helpful to you as a peer mentor?
a. How to do motivational interviewing
b. How to improve communication skills
c. How to help someone manage depression

3

d.
e.
f.

How to find community-based resources
Other (Specify)
None of the above

Q20. Now thinking about organizations other than the Reeve Foundation, in the past 12 months, have you
accessed any mentoring resources (e.g., books, websites) offered by these other organizations?
a. Yes
b. No
Q21. In the past 12 months, how many trainings for mentors offered by organizations other than the Reeve
Foundation have you attended?
a. I have not attended any trainings in the past 12 months
b. 1 training
c. 2 to 5 trainings
d. 6 to 10 trainings
e. More than 10 trainings
Q22. Thinking across all your mentor-peer relationships, what has been your most frequent challenge when in a
mentoring relationship?
a. Difficulty scheduling a mutually convenient time to talk
b. Not being able to provide emotional support
c. Not knowing the peer’s needs well enough
d. Not having enough information to address my peer’s concerns
e. Not being able to build a relationship with a peer
f. Lack of resources available to support a peer
g. Other (Specify)
Q23. What is your greatest challenge in volunteering as a mentor through the Reeve Foundation?
a. Receiving too many requests to mentor
b. Receiving too few requests to mentor
c. Too much training required
d. Inadequate training or preparation
e. Inadequate ongoing support from the Reeve Foundation
f. Lack of stipend or payment
g. Other (Specify)

Section 4. Outcomes
Q24. When you started volunteering as a mentor, what did you hope to achieve from participating in the Peer
Mentor program? Choose up to three of the following answers.
[PROGRAMMER: USE HIDE OPTION LOGIC FOR FILL INS. UPON SELECTION, SHOW FILL INS FOR Q25 TO Q27.2]
a. Improve mental health [FILL IN TEXT: your mental health]
b. Feel more confident to take action toward achieving life goals [FILL IN TEXT: your sense of confidence]
c. Strengthen my support network [FILL IN TEXT: your support network]
d. Participate more in community life [FILL IN TEXT: your ability to participate in community life]
e. Improve social skills [FILL IN TEXT: your ability to relate to others]
f. A sense of contribution to the community [FILL IN TEXT: your contribution to the community]
g. Other (Specify) [FILL IN TEXT: write in reason]
The following questions will ask about the types of things you hoped to achieve from volunteering in the Peer
Mentor program.

4

Q25. [IF Q2=a, then FILL2=”your paralysis”; ELSE IF Q2=b, then FILL2=”paralysis in someone you care for”] Thinking
about your situation before you became a mentor, to what extent did [FILL2] affect [PROGRAMMER: INSERT WITH
FILL IN OF FIRST ORDERED SELECTION IN Q24]
1
Not at all

2

3

4
Somewhat

5

6

7
To a great extent

Q26. On a scale from 1 to 7, how was [PROGRAMMER: INSERT FILL IN TEXT OF FIRST ORDERED SELECTION IN Q24]
just before becoming a peer mentor?
1
Poor

2

3

4
Neutral

5

6

7
Excellent

Q27. On a scale from 1 to 7, how is [PROGRAMMER: INSERT FILL IN TEXT OF FIRST ORDERED SELECTION IN Q24]
after volunteering as a peer mentor?
1
Poor

2

3

4
Neutral

5

6

7
Excellent

Q25.1 [IF Q2=a, then FILL2=”your paralysis”; ELSE IF Q2=b, then FILL2=”paralysis in someone you care for”]
Thinking about your situation before you became a mentor, to what extent did [FILL2] affect [PROGRAMMER:
INSERT WITH FILL IN OF SECOND ORDERED SELECTION IN Q24]
1
Not at all

2

3

4
Somewhat

5

6

7
To a great extent

Q26.1 On a scale from 1 to 7, how was [PROGRAMMER: INSERT FILL IN TEXT OF SECOND ORDERED SELECTION IN
Q24] just before becoming a peer mentor?
1
Poor

2

3

4
Neutral

5

6

7
Excellent

Q27.1 On a scale from 1 to 7, how is [PROGRAMMER: INSERT FILL IN TEXT OF SECOND ORDERED SELECTION IN
Q24] after volunteering as a peer mentor?
1
Poor

2

3

4
Neutral

5

6

7
Excellent

Q25.2 [IF Q2=a, then FILL2=”your paralysis”; ELSE IF Q2=b, then FILL2=”paralysis in someone you care for”]
Thinking about your situation before you became a mentor, to what extent did [FILL2] affect [PROGRAMMER:
INSERT WITH FILL IN OF THIRD ORDERED SELECTION IN Q24]
1
Not at all

2

3

4
Somewhat

5

6

7
To a great extent

Q26.2 On a scale from 1 to 7, how was [PROGRAMMER: INSERT FILL IN TEXT OF THIRD ORDERED SELECTION IN
Q24] just before becoming a peer mentor?
1
Poor

2

3

4
Neutral

5

6

7
Excellent

Q27.2 On a scale from 1 to 7, how is [PROGRAMMER: INSERT FILL IN TEXT OF THIRD ORDERED SELECTION IN Q24]
after volunteering as a peer mentor?
1
Poor

2

3

4
Neutral

5

6

7
Excellent

5

Q28. Overall, did participation in peer mentoring have the effect on your well-being that you expected?
a. Yes
b. No

Section 5. Background Information
Q29. How old are you?
a. 18 to 24
b. 25 to 34
c. 35 to 44
d. 45 to 54
e. 55 to 64
f. 65 or over
Q30. Which of the following describes you? Select all that apply.
a. American Indian/Alaska Native
b. Black/African American
c. Native Hawaiian/Pacific Islander
d. Asian
e. White/Caucasian
f. Some other race
99. Prefer not to answer
Q31. Are you of Hispanic, Latino, or Spanish origin or descent?
a. Yes
b. No
98. Don´t know
99. Prefer not to answer
Q32. What is the highest level of school you have completed?
a. Less than high school
b. High school or equivalent
c. Some college/university, no degree
d. College or university degree
e. Postgraduate degree
Q33. What sex were you assigned at birth, on your original birth certificate?
a. Female
b. Male
98. Don’t know
99. Prefer not to answer
Q34. What is your current gender? Female
a. Male
b. Transgender
c. [If Q29=a] Two-Spirit
d. I use a different term. (OPEN ENDED)
98. Don’t know
99. Prefer not to answer
Q35. Which of the following best represents how you think of yourself?
a. Lesbian or gay
b. Straight, that is, not gay or lesbian
c. Bisexual

6

d. [If Q29=a] Two-Spirit
e. I use a different term (Specify)
98. Don’t know
99. Prefer not to answer
Q36. [IF Q3=a, then question=“Please provide the approximate date of the onset of paralysis.”;
ELSE IF Q3=b, then question=“Please provide the approximate date of your caregiving role.”]
[PROGRAMMER: CALENDAR QUESTION FORMAT MONTH/YEAR]
98. Don´t know
Q37. [If Q3=a, then question=“What caused your paralysis? Select all that apply.”
Else if Q3=b, then question=“What caused the paralysis of the person you are providing care for? Select all that
apply.]
a.
b.
c.
d.
e.
f.
98.

Spinal cord injury
Brain injury
Disease or syndrome
Result of surgical or medical procedure
Stroke
Other (Specify)
Don’t know

Q38. [If Q3=a, then question=“What type of paralysis do you have? Choose one of the following answers.”
Else if Q3=b, then question= “What type of paralysis do you provide care for? Choose one of the following
answers.]
a. Paraplegia (T1 and below)
b. Hemiplegia
c. Quadriplegia (C8 and above)
d. Other (Specify)
98. Don’t know
[GO TO END2]

Section 6. End
END1. Thank you for your willingness to participate; however, you are ineligible at this time.
END2. We thank you for your time and cooperation in this study. Your anonymous responses are very important
and will help the Administration for Community Living improve its support to resource centers nationwide.
OMB No: 0985-NEW. This activity is authorized under the Paperwork Reduction Act. Data collected will be shared
with ACL staff, but your responses will be used for research and aggregate reporting purposes only and will not be
used for other non-statistical or non-research purposes. Public reporting burden for this collection of information
is estimated to average 15 minutes, including the time for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed, 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 [email protected].

7


File Typeapplication/pdf
File Modified2023-02-27
File Created2023-02-27

© 2024 OMB.report | Privacy Policy