Sexual Risk Avoidance Education National Evaluation: Co-regulation Guidance Pilot Study

Formative Data Collections for ACF Research

Instrument 2_Post training pulse check_final

Sexual Risk Avoidance Education National Evaluation: Co-regulation Guidance Pilot Study

OMB: 0970-0356

Document [docx]
Download: docx | pdf

SRAENE – Core Components Evaluation, Co-Regulation Strategies, Instrument 2

OMB Control No: 0970-0356

Expiration Date: 01/31/2027



Sexual Risk Avoidance Education National Evaluation 2.0

Facilitator post-training pulse check [web-based]



Thank you in advance for taking this survey! This study is sponsored by the Administration for Children and Families (ACF) within the U.S. Department of Health and Human Services and is being conducted by Mathematica. The purpose of this short survey is to learn about your experience with the training you received on the co-regulation strategies. The information you provide will help ACF learn about and improve training on the co-regulation strategies.

Your participation in this survey is voluntary. There are no risks or benefits associated with completing the survey, which should take about 5 minutes. We will not collect any personal information (for example, your name, email, or phone number) as part of the survey. Your answers will remain private, except as required by law, and no staff at your organization will see your individual responses. We hope you answer all survey questions, but you may skip any question you do not want to answer.

If you have any questions or comments about this information collection, contact Melissa Thomas, the survey director, at [email protected] or (609) 275-2231. If you have any questions or concerns about your rights as a study participant, please contact the Health Media Lab Institutional Review Board at (202) 246-8504.

If you agree to participate in this survey, click NEXT to begin. If you do not agree to participate, please close out of this window.



  1. Overall, how satisfied were you with this training?

  • Not at all satisfied

  • Somewhat satisfied

  • Satisfied

  • Very satisfied


  1. Which part(s) of the training do you think went particularly well? (check all that apply)

  • Learning about youth self-regulation

  • Learning about the co-regulation strategies

  • Completing the worksheets

  • Practicing the strategies

  • Question and answer discussions

  • Other, please specify


  1. Which part(s) of the training do you think could be improved? (check all that apply)

    • Learning about youth self-regulation

    • Learning about the co-regulation strategies

    • Completing the worksheets

    • Practicing the strategies

    • Question and answer discussions

    • Other, please specify


  1. This training was:

  • Too short

  • Just right

  • Too long


  1. The format of this training was:

    • Helpful for learning about and practicing the co-regulation strategies

      1. If so, why (open-ended)?

    • Not helpful for learning about and practicing the co-regulation strategies

      1. If so, why (open-ended)?


  1. After this training, how confident do you feel in your ability to begin to use the co-regulation strategies when facilitating?

  • Not at all confident

  • Somewhat confident

  • Confident

  • Very confident


  1. Anything else you’d like to add about the training?









THE PAPERWORK REDUCTION ACT OF 1995

This collection of information is voluntary and will be used to provide the Administration for Children and Families with information to help refine and guide program development in the area of adolescent pregnancy prevention. Public reporting burden for the collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, gathering and maintaining the data needed, 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. The OMB number and expiration date for this collection are OMB #: 0970-0356, Exp: 01/31/2027. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Melissa Thomas at [email protected]..



DRAFT 05/29/25 Mathematica® Inc. 3

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File Title1-column report template
AuthorCaroline O'Callahan
File Modified0000-00-00
File Created2025-05-29

© 2025 OMB.report | Privacy Policy