OMH MLDP Fellow Post Program Questionaire_5.23(OMB)

Fellow Post Program Questionnaire

OMH Minority Leadership Development Program

Contents

Section I: Demographics 2

Section II: Public Health Background 3

Section III: Public Health Knowledge & Skills 4

Section IV: Leadership Skills & Characteristics 4

Section V: TBD 5

Section VI: TBD 5

Section VII: TBD 6

Section I: Demographics

1. How old are you?

1. 21-25

2. 25-30

3. 31-35

4. 36-40

5. 40 & above

2. What HHS region of the U.S. did you reside in prior to the fellowship program?

1. Region 1: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont

2. Region 2: New Jersey, New York, Puerto Rico, and the Virgin Islands

3. Region 3: Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia

4. Region 4: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee

5. Region 5: Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin

6. Region 6: Arkansas, Louisiana, New Mexico, Oklahoma, and Texas

7. Region 7: Iowa, Kansas, Missouri, and Nebraska

8. Region 8: Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming

9. Region 9: Arizona, California, Hawaii, Nevada, American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Marshall Islands, and Republic of Palau

10. Region 10: Alaska, Idaho, Oregon, and Washington

3. What is your racial background?

1. Black or African American

2. American Indian or Alaska Native

3. Native Hawaiian or Pacific Islander

4. Asian American - Eastern

5. Asian American - Indian

6. Multiracial

7. Other:

4. Are you of Hispanic, Latino, or Spanish origin?

1. Yes

2. No

4a. If yes, what is your country origin?

5. How would you describe your gender?

1. Woman

2. Man

3. Transgender

4. Non-Binary/Non-Conforming

5. Prefer not to answer

Section II: Public Health Background

6. How many public health classes have you taken?

1. 0

2. 1-3

3. 4-6

4. More than 6

7. How many years of public health experience do you have?

1. 0

2. 1-5

3. 6-10

4. 11-15

8. Which best describes your public health experience?

1. Academia

2. Community-based/Non-Profit

3. Clinical

4. Local/State Government

5. Federal Government

6. Other

8a. If other, how would you describe your public health experience?

9. Are you a member of any professional public health organizations?

1. Yes

2. No

10. Do you have any professional certifications?

1. Yes

2. No

10a. If yes, please list your professional certifications.

11. What are your public health career interests? (Ex. Maternal/Child Health; Communicable Disease; Environmental Health)

12. How has this fellowship enhanced your public health background?

Section III: Public Health Knowledge & Skills

Instructions: We are interested in how you feel about the following statements. Read each statement and indicate how you feel about each statement.

Based on the information and training I received during the OMH Minority Leadership Development Program:

1. Strongly Agree B. Agree C. Neutral D. Disagree E. Strongly Disagree

13. I understand the various root causes of health disparities in the United States.

14. I understand how social determinants impact health disparities.

15. I understand the various forms of racial disparities in the United States.

16. I understand the concept of health equity.

17. I understand how the concepts of culture, cultural awareness, cultural humility, and cultural competence impact public health.

18. I understand how social justice impacts public health.

19. I understand how structural violence impacts public health.

20. I understand how health policy influences population health.

21. I am confident in discussing health disparities with various audiences.

Section IV: Leadership Skills & Characteristics

Instructions: We are interested in how you feel about the following statements. Read each statement and indicate how you feel about each statement.

Based on the information and training I received during the OMH Minority Leadership Development Program:

1. Strongly Agree B. Agree C. Neutral D. Disagree E. Strongly Disagree

22. I understand my leadership style and characteristics.

23. I understand the difference between leadership and management.

24. I understand the federal organizational structure.

25. I am comfortable engaging various levels of stakeholders.

26. I am comfortable with leading and managing change in professional environments.

27. I am comfortable with forging new partnerships and collaborating with colleagues.

Section V: Module Sessions/ Fellow’s Connect Café

Instructions: We are interested in how you feel about the following statements. Read each statement and indicate how you feel about each statement.

Based on the information and training I received during the OMH Minority Leadership Development Program:

1. Strongly Agree B. Agree C. Neutral D. Disagree E. Strongly Disagree

28. I was pleased with the format and delivery of the program.

29. The MLDP curriculum enhanced my knowledge of each module topic.

30. The live curriculum module sessions and supplemental resources helped enhance the fellowship experience.

31. The module facilitators adequately explained the goals and objectives of each module.

32. I was comfortable adding additional dialogue in each module session.

33. The information presented at the Fellows Connect Café Sessions was helpful.

34. The facilitators engaged in the live module and Fellows Connect Café sessions.

35. The facilitators engaged in the live module and Fellows Connect Café sessions.

Section VI: Host Site Experience

Instructions: We are interested in how you feel about the following statements. Read each statement and indicate how you feel about each statement.

Based on the information and training I received during the OMH Minority Leadership Development Program:

1. Strongly Agree B. Agree C. Neutral D. Disagree E. Strongly Disagree

36. I was pleased with the fellowship placement.

37. I was pleased with my onboarding and orientation experience at the HHS agency.

38. My fellowship placement helped expand my public health knowledge and leadership skills.

39. I believe the experience I gained from my fellowship placement will help me (or has helped me) gain federal employment.

40. I was pleased with my host site mentor.

41. My host site’s mentor’s guidance on my assigned tasks were helpful.

42. I am pleased with the overall knowledge and experience gained during the fellowship.

Section VII: Fellowship Experience

43. Overall, I am pleased with the knowledge and skills gained in the MLDP fellowship.

1. Strongly Agree

2. Agree

3. Neutral

4. Disagree

5. Strongly Disagree

44. In your opinion, how can future OMH fellowship experiences be enhanced?

45. In your opinion, what curriculum components should be added or removed from future OMH fellowships?

46. If you have additional comments about your experience, facilitators, or the fellowship program in general, please include them here: