22 - Requester Feedback

REQUESTER
FEEDBACK

OMB Control Number: 0970-0519
Expiration Date: 05/31/2020

Form

In order to help the National Human Trafficking Training and Technical Assistance Center (NHTTAC) better serve the field, we
are reaching out to obtain your feedback. We will protect the privacy of your information in accordance with the Federal Privacy
Act, and we will protect the confidentiality of your responses using procedures we have in place, including reporting all
information in aggregate to avoid identifying information. Only members of the NHTTAC Evaluation Team have access to
information that could identify respondents. If you have any questions about this survey or the evaluation, please contact
[email protected].
REQUESTER NAME/AGENCY:
CONSULTANT(S)/PRESENTER(S):
NHTTAC TRAINING/TECHNICAL ASSISTANCE SPECIALIST:

1.

Please select the type of training and technical assistance (T/TA) you requested:


Needs assessment



Review of materials (e.g., protocols,
screening forms, etc.)



Organization audit



SOAR for communities



Remote training



In-person SOAR training



Training of trainers



In-person training



SOAR training for HHS personnel



Peer-to-peer collaboration



Coaching




Strategic partnerships for SOAR Online
Other (please specify):



Mentorship

Please indicate the extent to which you were satisfied or not satisfied with your overall experience working with NHTTAC:

2.

Very
Dissatisfied

Dissatisfied

Satisfied

Very
Satisfied

1

2

3

4

1

2

3

4

3.

The overall quality of the support you received from NHTTAC
staff
Your overall experience with NHTTAC staff

4.

Your interactions with NHTTAC staff

1

2

3

4

5.

Your interactions with the consultants

1

2

3

4

6.

The quality of support you received from NHTTAC staff during the
needs assessment process
The quality of support you received from the consultants in
implementing the T/TA

1

2

3

4

1

2

3

4

7.

Please indicate the extent to which you agree or disagree with the following statements about your interactions with NHTTAC
staff and the planning process:

PLANNING
8.

NHTTAC was responsive to my questions and needs.

Strongly
Disagree

Disagree

Agree

Strongly
Agree

1

2

3

4

PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information
collection is to enable NHTTAC to collect recipient and stakeholder feedback to improve NHTTAC’s T/TA service delivery. Public reporting
burden for this collection of information is estimated to average 0.117 hours per respondent, 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. 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. If you have any comments on this collection of
information, please contact the NHTTAC Evaluation Team at [email protected] or 9300 Lee Highway, Fairfax, VA 22031.

REQUESTER
FEEDBACK

OMB Control Number: 0970-0519
Expiration Date: 05/31/2020

Form
9.

NHTTAC was effective in identifying an appropriate
consultant/presenter.
10. NHTTAC staff was detail oriented and thorough in the planning of
this T/TA.

1

2

3

4

1

2

3

4

1

2

3

4

Strongly
Disagree

Disagree

Agree

Strongly
Agree

1

2

3

4

1

2

3

4

1

2

3

4

15. As a result of the needs assessment, [I][my organization] can….

1

2

3

4

16. As a result of the needs assessment, [I][my organization] can….

1

2

3

4

17. As a result of the needs assessment, [I][my organization] can….

1

2

3

4

11. NHTTAC was timely throughout the planning process.

NEEDS ASSESSMENT
12. NHTTAC helped me determine the most important needs are for
[me][my organization] to address human trafficking.
13. NHTTAC helped me determine the most important needs are for
[me][my organization] to .
14. NHTTAC helped me determine the most important needs are for
[me][my organization] to .

18. What aspects of the NHTTAC planning process were most helpful, and why?

19. What aspects of the needs assessment were most helpful, and why?

Please indicate the extent to which you agree or disagree with the following statements about the consultants:

CONSULTANT 1:

Strongly
Disagree

Disagree

Agree

Strongly
Agree

20. The consultant was easy to communicate with in planning for the T/TA.

1

2

3

4

21. The consultant responded to me in a timely manner.

1

2

3

4

22. The consultant was respectful.

1

2

3

4

23. The consultant’s knowledge and expertise were appropriate for my needs.

1

2

3

4

Strongly
Disagree

Disagree

Agree

Strongly
Agree

24. The consultant was easy to communicate with in planning for the T/TA.

1

2

3

4

25. The consultant responded to me in a timely manner.

1

2

3

4

26. The consultant was respectful.

1

2

3

4

27. The consultant’s knowledge and expertise were appropriate for my needs.

1

2

3

4

CONSULTANT 2:

28. Would you recommend [NHTTAC][SOAR] T/TA to others to receive T/TA?

□ Yes

□ No

PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information
collection is to enable NHTTAC to collect recipient and stakeholder feedback to improve NHTTAC’s T/TA service delivery. Public reporting
burden for this collection of information is estimated to average 0.117 hours per respondent, 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. 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. If you have any comments on this collection of
information, please contact the NHTTAC Evaluation Team at [email protected] or 9300 Lee Highway, Fairfax, VA 22031.

REQUESTER
FEEDBACK

OMB Control Number: 0970-0519
Expiration Date: 05/31/2020

Form
29. What suggestions do you have for improving NHTTAC’s support of T/TA planning and/or delivery?

30. What additional needs do you or your organization have regarding this topic?

31. Which of the following best describes the organization in which you work? (Mark all that apply.)
 Academic institution
OTIP grantee
Anti-trafficking organization
Self-employed
Business/For-profit organization
Survivor-led organization
Coalition/Multidisciplinary team/Task force
Tribal government
Federal government
Union/Worker advocacy organization
Faith-based organization
Victim service provider
State and local government
Other (please specify):
Nonprofit/Community-based organization
32. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□ Yes
□ No
33. Which of the following best describes your professional capacity or types of services you provide? (Mark all that apply.)











Behavioral health professional (e.g., psychologist,
psychiatrist, mental health/substance use counselor)
Child welfare (e.g., state agency staff, child welfare
contractor, nonprofit personnel)
Corrections-based services (e.g., parole, probation)
Criminal justice (e.g., law enforcement, prosecutor,
probation, court, forensic interviewer)
Educator (e.g., teacher, professor, school
administrator)
Health care (e.g., physician, physician assistant,
nurse practitioner, dentist, nurse, pharmacist)
Housing (e.g., case worker, shelter director, public
housing authority agencies)







Legal (e.g., immigration, civil and/or rightsbased attorney and/or paralegal, clinic)
Public health (e.g., licensure board, health
department staff, health care executive,
community health workers)
Social worker (e.g., case manager,
school counselor, supervisor,
administrator)
Survivor empowerment, mentoring, or peer to peer
Violence prevention (e.g., child abuse and
neglect, elder abuse, domestic violence, sexual
violence, youth violence)
Other (please
specify):

34. In your professional capacity, how frequently do you come into contact with a person who is currently being trafficked, at
risk of being trafficked, or has been trafficked?
1

2

3

4

Never

Occasionally

Frequently

Daily

PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information
collection is to enable NHTTAC to collect recipient and stakeholder feedback to improve NHTTAC’s T/TA service delivery. Public reporting
burden for this collection of information is estimated to average 0.117 hours per respondent, 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. 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. If you have any comments on this collection of
information, please contact the NHTTAC Evaluation Team at [email protected] or 9300 Lee Highway, Fairfax, VA 22031.

REQUESTER
FEEDBACK

OMB Control Number: 0970-0519
Expiration Date: 05/31/2020

Form
35. Which of the following best describes the number of years of experience you have in your current field of work?
□

Less than 3 years

□

□

3–5 years

□

6–10 years

More than 10 years

36. Which of the following best describes your primary role in your current position?
□

Direct delivery/Frontline staff

□

Consultant/Trainer

□

Administration

□
□

Management
Other (please specify):

□

Volunteer

□

Peer Educator

37. Which of the following best describes your geographic population? (Mark all that apply.)
□

□
□
□

National
State (please specify):
Tribal
International (please specify country):

□

Local
□ Urban
□ Rural
□ Suburban

38. Please select any of the following populations you currently work with in a professional capacity. (Mark all that apply.)
Human trafficking
 Commercial sexual exploitation of
children
 Sex trafficking
 Adults
 Minors
 Labor trafficking
 Adults
 Minors
Children/youth
 Out of home/Foster care/Kinship care
 Juvenile justice
 Runaway/Homeless youth
People with disabilities
Deaf/Hearing impaired
Elderly
Lesbian, gay, bisexual, transgender, and
questioning

Foreign nationals (migrant workers, undocumented
immigrants, refugees)
People with low incomes
Racial and ethnic minorities
 American Indian or Alaska Native
 Asian
 Black or African American
 Native Hawaii or other Pacific Islander
 White
 Hispanic or Latino ethnicity
History of substance use
Intimate partner violence (e.g., dating, domestic
violence)
Gang-related crime
Sexual abuse/Violence
Other (please specify):

39. Do you have any other comments or suggestions you would like to share about your [NHTTAC][SOAR] experience?

Thank you for taking the time to complete this form and helping to improve NHTTAC activities.

PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information
collection is to enable NHTTAC to collect recipient and stakeholder feedback to improve NHTTAC’s T/TA service delivery. Public reporting
burden for this collection of information is estimated to average 0.117 hours per respondent, 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. 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. If you have any comments on this collection of
information, please contact the NHTTAC Evaluation Team at [email protected] or 9300 Lee Highway, Fairfax, VA 22031.