5 Family Focus Group Recruitment Survey

Family Focus Group Recruitment Survey

Burden Statement: The purpose of this study is to explore how family voice and leadership activities are implemented in the Maternal, Infant, and Early Childhood Home Visiting Program. 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. The OMB control number for this information collection is 0906-XXXX and it is valid until XX/XX/202X. This information collection is voluntary. Data will be kept private to the extent allowable by the law. Public reporting burden for this collection of information is estimated to average X hours per response, including the time for reviewing instructions, searching existing data sources, 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 HRSA Information Collection Clearance Officer, 5600 Fishers Lane, Room 14N39, Rockville, Maryland, 20857 or [email protected]. Please see https://www.hrsa.gov/about/508-resources for the HRSA digital accessibility statement. 

Hello! We are researchers from Child Trends, a non-partisan research organization focused on improving the lives of children and families. We are working on a project, funded by the Health Resources and Services Administration (HRSA), to learn about family voice and leadership activities in home visiting programs across the country. By “family voice and leadership”, we mean opportunities for families to be included in decision making about their home visiting programs beyond their own personal visits. Specifically, we are hoping to learn about the types of family voice and leadership opportunities available, families’ experiences participating in these opportunities, and what impact family leaders may be having on home visiting.

As part of our project, we are hoping to talk with families who have participated in family voice and leadership activities through their home visiting programs. You are receiving this survey because someone from your home visiting program thought you may be interested in participating in a virtual focus group discussion to share your experiences as a family leader.

If you are interested in being invited to a focus group, please fill out the questions below:

1. In what language would you like to take this survey?

   1. English

   2. Spanish

2. Have you participated as a family leader in your home visiting program in the last 3 years?

   1. Yes

   2. No—END SURVEY

3. [If yes to #2] Please briefly describe your experience as a family leader in your home visiting program.

4. [If yes to #2] Are you interested in participating in a one-hour focus group discussion about your experiences as a family leader? Discussions will be held virtually, and participants will receive a $50 gift card to Amazon or Walmart.

   1. Yes

   2. No—END SURVEY

5. What is your name?

6. What is your email address?

7. What is your phone number?

8. How would you like us to contact you with more information about a focus group discussion? (select all that apply)

   1. Phone call

   2. Text message

   3. Email

9. In what language would you like to participate in a focus group discussion? (select all that apply)

   1. English

   2. Spanish

10. Do you live in a Tribal nation? (e.g., Cherokee Nation, Navajo Nation)

    1. Yes

    2. No

11. [If no to #10] In what state or territory do you live?

    1. Dropdown

12. What is your race or ethnicity (select all that apply)?

    1. American Indian or Alaska Native (e.g., Navajo Nation, Blackfeet Tribe, Mayan, Aztec, Native Village of Barrow Inupiat Tribal Government, Tlingit)

    2. Asian (e.g., Chinese, Filipino, Asian Indian, Vietnamese, Korean, Japanese)

    3. Black or African American (e.g., African American, Jamaican, Haitian, Nigerian, Ethiopian, Somali)

    4. Hispanic or Latino (e.g., Mexican or Mexican American, Puerto Rican, Cuban, Salvadoran, Dominican, Colombian)

    5. Middle Eastern or North African (e.g., Lebanese, Iranian, Egyptian, Syrian, Moroccan, Israeli)

    6. Native Hawaiian or Pacific Islander (e.g., Native Hawaiian, Samoan, Chamorro, Tongan, Fijian, Marshallese)

    7. White (e.g., German, Irish, English, Italian, Polish, French)

    8. Another race or ethnicity (please explain)

    9. Prefer not to answer

Thank you for your interest! Someone from our study team will be in touch with you with more information about joining a focus group discussion.