Strategies To Respond to Intimate Violence Effectively (STRIVE)

Formative Data Collections for ACF Program Support

Instrument 2. RF pre and post survey

Strategies To Respond to Intimate Violence Effectively (STRIVE)

OMB: 0970-0531

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STRIVE Responsible Fatherhood (RF) Survey

Thank you for taking this survey. As a reminder, you can skip any questions you don’t want to answer, and your name will not be associated with your answers. These questions should take around 5 to 10 minutes to complete.

The first questions of this survey ask what you think about healthy and unhealthy or harmful relationships.

Please indicate how much you agree or disagree.

  1. I have a clear sense of what a healthy and supportive relationship looks like.

  • Strongly agree

  • Agree

  • Neither agree nor disagree

  • Disagree

  • Strongly disagree



  1. Please indicate how much you agree or disagree with each of the following statements.



Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

In a healthy relationship, each partner spends time on their own without the other.






An important part of resolving problems in relationships is deciding who’s at fault.






If one partner spies on the other, there is probably a good reason for it.






It’s normal for one partner to feel scared of the other partner during disagreements.







  1. Please identify whether these hypothetical relationship situations are considered healthy, harmful, or may depend on the details of the situation.


Healthy

Harmful

Depends on the details of the situation

Don’t know

One partner says embarrassing things about the other to make their friends laugh.





One partner sometimes tells the other partner not to go places.





One partner is in charge of how the other partner can spend their money.





One partner yells or curses at the other partner during an argument but then apologizes.





One partner makes the other partner feel guilty if they don’t want to have sex.





One partner hits the other partner when they get angry.







  1. If someone is abusive in their relationship, they can change their behavior.

  • Strongly agree

  • Agree

  • Neither agree nor disagree

  • Disagree

  • Strongly disagree


The questions below ask about an intimate relationship. An intimate relationship could refer to a dating partner, girlfriend/boyfriend, hook-ups, spouse, or domestic partner.

Please indicate how much you agree or disagree.

  1. I am comfortable talking with a trusted friend or relative about any challenges I am having in an intimate relationship.

  • Strongly agree

  • Agree

  • Neither agree nor disagree

  • Disagree

  • Strongly disagree


  1. I am comfortable talking with a program staff member about any challenges I am having in an intimate relationship.

  • Strongly agree

  • Agree

  • Neither agree nor disagree

  • Disagree

  • Strongly disagree



  1. There are some things that have happened in my intimate relationship that I don’t feel comfortable talking about with anyone.

  • Strongly agree

  • Agree

  • Neither agree nor disagree

  • Disagree

  • Strongly disagree


For the following questions, think about any friends or relatives who you are close with.

Please indicate how much you agree or disagree.

  1. I feel comfortable approaching a friend or relative to talk if I’m concerned about their safety or wellbeing in their relationship.

  • Strongly agree

  • Agree

  • Neither agree nor disagree

  • Disagree

  • Strongly disagree


  1. I know what resources to suggest to a friend or relative if I’m concerned about their safety or wellbeing in their relationship.

  • Strongly agree

  • Agree

  • Neither agree nor disagree

  • Disagree

  • Strongly disagree

The following questions ask about how you handle conflict in your family.

  1. I take steps to manage my feelings when there is conflict in my family, and when I feel upset or frustrated.

  • Strongly agree

  • Agree

  • Neither agree nor disagree

  • Disagree

  • Strongly disagree


  1. I use the following strategies when I feel upset or frustrated during conflict:

  • Pay attention to changes in my body

  • Try to pause or slow down

  • Go for a walk

  • Splash cold water on my face

  • Take deep breaths

  • Become aware of negative thoughts

  • Change what I tell myself about the conflict

  • None of the above



The last few questions ask about safety. When we use the word safety here, we mean safety from abuse by another person. This could include physical, sexual, emotional, or other forms of abuse.

  1. I am comfortable asking for help to keep safe from abuse by a current or former intimate partner.

  • Not at all true

  • A little true

  • Somewhat true

  • Very true

  • I don’t know


  1. Please mark which programs or services, if any, you know how to access:

  • A national hotline for parents who want support or advice

  • A national hotline for adults who are being abused by an intimate partner, or who are harming their intimate partner

  • A referral system for a range of local services

  • None of the above


  1. How likely are you to share information about these types of programs or services with someone you know?

  • Not at all likely

  • A little likely

  • Somewhat likely

  • Very likely

  • I don’t know


PRE ONLY

These last few questions ask about you and your background. We are asking these questions so we can describe some characteristics of the people who participated in this study when we report our findings.

  1. What race/ethnicity do you identify as? Select all that apply

  • Hispanic or Latino

  • American Indian or Alaska Native

  • Asian

  • Black or African American

  • Middle Eastern or North African

  • Native Hawaiian or other Pacific Islander

  • White or Caucasian



  1. Which of the following best describes your sex?

  • Female (woman)

  • Male (man)

  • Prefer not to disclose



  1. How old are you?

[Open-ended]


  1. What is the highest level of education you have completed?

  • No high school degree or diploma

  • High school diploma, GED, or High School Equivalency Test (HSE)

  • Vocational or technical certification

  • Some college but no degree or diploma

  • Associate or two-year college degree

  • Bachelor’s or four-year college degree or higher



  1. Which of the following categories best describes your employment status?

  • Full-time employed (usually work 35 or more hours a week)

  • Part-time employed (usually work 1-34 hours a week)

  • Employed but number of hours changes from week to week

  • Not currently employed, but actively looking for work

  • Not currently employed, and not looking for work



  1. What is your current relationship status?

  • Married

  • In a committed relationship but not married

  • In a dating relationship

  • Not in a romantic relationship


  1. If you are currently in a romantic relationship, do you live with your romantic partner?

  • Yes

  • No



POST ONLY

Recently you had a conversation with a [program name] staff person where you talked about parenting and relationship challenges. Please think about that conversation when you answer the following questions.

  1. During this conversation, did the staff person provide you with two copies of the safety card pictured here?

[Safety card image]

  • Yes, I received two copies of the safety card

  • Yes, but I only received one copy of the safety card

  • No, I did not receive the safety card

  • I don’t remember



  1. How useful did you find the information on the safety card?

  • Very useful

  • Somewhat useful

  • Not very useful



  1. Is there anything that would have made the safety card more useful to you?

[Open-ended]

  1. How comfortable were you with the conversation?

  • Very comfortable

  • Pretty comfortable

  • Not very comfortable


  1. How openly did you talk with the staff person?

  • Very openly

  • Somewhat openly

  • Not at all openly

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorSydney Briggs
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File Created2025-07-04

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