Form 1 Survey

OMB# 0925-0648

Expiration Date:06/30/2024

Public reporting burden for this collection of information is estimated to average 1 minute per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number (OMB# 0925-0648; Exp date 6/30/2024). Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0648). Do not return the completed form to this address.

Roundtable on Preventing Harassment in Isolated Scientific Research Environments

Hosted by the Interagency Working Group on Inclusion in STEM

Tuesday, November 1st, 2022

2 pm – 4 pm Eastern

Virtual webinar

Post-event customer feedback questions

1. Please rate your level of agreement with the following statement on a scale of 1 to 5.
   
   I learned something new and useful while I attended the Roundtable on Preventing Harassment in Isolated Scientific Research Environments
   
   

• 1 = Strongly disagree

• 2 = Somewhat disagree

• 3 = Neither agree nor disagree

• 4 = Somewhat agree

• 5 = Strongly agree

2. Please rate your level of agreement with the following statement on a scale of 1 to 5.
   
   The length and format of the Roundtable on Preventing Harassment in Isolated Scientific Research Environments were appropriate to the topic.
   
   

• 1 = Strongly disagree

• 2 = Somewhat disagree

• 3 = Neither agree nor disagree

• 4 = Somewhat agree

• 5 = Strongly agree

3. Please rate your level of agreement with the following statement on a scale of 1 to 5.
   
   The speakers at the Roundtable on Preventing Harassment in Isolated Scientific Research Environments brought a variety of perspectives that complemented each other.
   
   

• 1 = Strongly disagree

• 2 = Somewhat disagree

• 3 = Neither agree nor disagree

• 4 = Somewhat agree

• 5 = Strongly agree

4. Please rate your level of agreement with the following statement on a scale of 1 to 5.
   
   The Roundtable on Preventing Harassment in Isolated Scientific Research Environments achieved the following goals: (1) raise awareness of the extent of harassment in scientific research environments and its forms; (2) present examples of how organizations and individuals are addressing harassment in various research environments, and; (3) provide resources for organizations and individuals working to create effective, actionable policies to address harassment in research environments.
   
   

• 1 = Strongly disagree

• 2 = Somewhat disagree

• 3 = Neither agree nor disagree

• 4 = Somewhat agree

• 5 = Strongly agree

5. How did you learn about this event? (Select all that apply)
   
   

• Email forward from an individual

• Federal Committee on Science Technology Engineering and Math (FC-STEM) listserv

• National Science and Technology Council (NSTC) Committee on Science, Technology, Engineering and Math Education (CoSTEM) listserv

• Other Government listserv not including FC-STEM or NTSC/CoSTEM

• Non-Government listserv

• Search engine

• Social media

• Word of mouth