Form 9600-035 Train-the-Trainer Post-Survey

OMB Control No. 2030-0051

Expiration Date 5/31/2024

Train-the-Trainer Post-Survey

 

This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2030-0051). Responses to this collection of information are voluntary (40 CFR §745). 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 public reporting and recordkeeping burden for this collection of information is estimated to range from five to fifteen minutes per response. Send comments on the Agency’s need for this information, the accuracy of the provided burden estimates and any suggested methods for minimizing respondent burden to the Regulatory Support Division Director, U.S. Environmental Protection Agency (2821T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.  

 

This survey is anonymous, and EPA will use your answers solely to modify outreach for future upcoming sessions. We will not share this information with any third party. 

 

Thank you for your participation in a Lead Awareness Curriculum Train-the-Trainer session. As a follow-up to your participation, EPA has designed a short survey to gather information about your experience. Thank you for taking the time to answer our questions. We will use this information to improve our future sessions.  

 

Survey Questions: 

 

1. In which community are you located? 

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2. How well informed are you about the risk of lead exposure and lead poisoning in your community? 

   1. Scale: 1 (Not informed) – 2 (Slightly informed) – 3 (Moderately informed) – 4 (Well informed)

3. How familiar are you with lead poisoning prevention efforts in your community? 

   1. Scale: 1 (Not familiar) – 2 (Slightly familiar) – 3 (Moderately familiar) – 4 (Very familiar)

 

4. Now that you’ve participated in a session designed to improve your ability to provide effective training on preventing lead exposure, how confident are you in your ability to educate others about lead, its impacts, and lead prevention efforts?

   1. Scale: 1 (Not confident) – 2 (Slightly confident) – 3 (Moderately confident) – 4 (Very confident) 

 

5. How confident are you in your ability to use the Lead Awareness Curriculum to educate others about lead, its impacts, and lead prevention efforts?

   1. Scale: 1 (Not confident) – 2 (Slightly confident) – 3 (Moderately confident) – 4 (Very confident) 

6. How likely is it that you or your organization will implement one or more modules of the Lead Awareness Curriculum in your community? 

   1. Scale: 1 (Not likely) – 2 (Slightly likely) – 3 (Moderately likely) – 4 (Very likely)

7. Which of the modules from the Lead Awareness Curriculum will you or your organization most likely use as part of your work?

   1. Module 1: Understanding Lead

      1. Scale: 1 (Not likely) – 2 (Slightly likely) – 3 (Moderately likely) – 4 (Very likely)

   2. Module 2: Effective Cleaning Techniques

      1. Scale: 1 (Not likely) – 2 (Slightly likely) – 3 (Moderately likely) – 4 (Very likely)

   3. Module 3: Personal Hygiene and Nutrition

      1. Scale: 1 (Not likely) – 2 (Slightly likely) – 3 (Moderately likely) – 4 (Very likely)

   4. Module 4: Hiring Certified Lead Professionals

      1. Scale: 1 (Not likely) – 2 (Slightly likely) – 3 (Moderately likely) – 4 (Very likely)

 

8. How clear was the information provided in the Lead Awareness Curriculum Train-the-Trainer session?   

   1. Scale: 1 (Not clear) – 2 (Slightly clear) – 3 (Moderately clear) – 4 (Very clear)

9. How engaging was the session instructor?

   1. Scale: 1 (Not engaging) – 2 (Slightly engaging) – 3 (Moderately engaging) – 4 (Very engaging)  

10. What one or two recommendations would you have for improving future Lead Awareness Curriculum Train-the-Trainer sessions?

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Thank you for taking the time to fill out this survey! For more information about the Lead Awareness Curriculum or to be added to our listserv, please visit: www.epa.gov/lead/tribal-lead-curriculum.  

 

EPA Form: 9600-035