Healthy Marriage and Responsible Fatherhood Local Evaluation Technical Assistance (HMRF-LETA)

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HMRF-LETA EVALUATION BENCHMARK TRACKING FORM
This form collects key evaluation benchmarks from HMRF grantees conducting local evaluations. 
Instructions: 
    • Have your evaluation enrollment and data collection numbers ready before starting.
    • Complete Section A. 
    • Complete Sections B and C. The form will show only the questions that apply to your evaluation based on your design type and data collection methods.
    • Finally, complete Section D.
    • All questions are cumulative since the start of your local evaluation enrollment unless otherwise noted. 
    • If a question does not apply, enter N/A.
Section A. Grantee Information
First, we would like to ask for some basic information about your HMRF program and the local evaluation.
    • A_Q1. Please enter the Grantee Name. [Text entry field]	
Submissions
    • A_Q2. What date are you reporting through? [Date entry field]
    • A_Q3. Who is completing this form? Please enter your name and role. [Text entry field]
Design type
    • A_Q4. Please select your evaluation design type(s). [Select all that apply]
        ◦ Descriptive Outcome   
        ◦ Impact
        ◦ Implementation
        ◦ Formative
        ◦ Measurement
    • A_Q5. Please select the types of data you plan to collect for your evaluation. [Select all that apply]
        ◦ Quantitative Data
        ◦ Qualitative Data
Section B. Enrollment 
Next, we would like to ask you about your enrollment sample sizes:
    • B_Q1. How many program participants overall have consented and enrolled in your evaluation? [Numeric entry field]	
[If A_Q4 != Impact, skip to Section C]
    • B_Q2. How many of the participants enrolled in the evaluation are in the treatment group? [Numeric entry field]	
    • B_Q3. How many of the participants enrolled in the evaluation are in the comparison or control group? [Numeric entry field]	


Section C. Data collection
Now we would like to ask about your evaluation data collection progress.
[If A_Q5 = Quantitative]
[If A_Q4!= Impact] 
Evaluations without a comparison group
Wave 1 (e.g., baseline or entrance survey)
    • C_Q1A. How many participants overall are eligible to complete your first local evaluation survey? [Numeric entry field]	
    • C_Q1B. How many participants overall have completed your first local evaluation survey? [Numeric entry field]	
Wave 2 (e.g., exit survey)
    • C_Q2A. How many participants overall are eligible to complete your second local evaluation survey? [Numeric entry field]
    • C_Q2B. How many participants overall have completed your second local evaluation survey? [Numeric entry field]
Wave 3 (e.g., 6-month follow-up survey)
    • C_Q3. Does your evaluation include a third survey (e.g., a follow-up survey after program exit)? [Selection field: Yes/No]
[If C_Q3 = No, skip to C_Q10]
    • C_Q3A. How many participants overall are eligible to complete your third local evaluation survey? [Numeric entry field]
    • C_Q3B. How many participants overall have completed your third local evaluation survey? [Numeric entry field]
[Go to C_Q10]
[If A_Q4= Impact] 
Impact evaluations
Wave 1 (e.g., baseline or entrance survey)
    • C_Q4A. How many treatment group participants overall are eligible to complete your first local evaluation survey? [Numeric entry field]	
    • C_Q4B. How many treatment group participants overall have completed your first local evaluation survey? [Numeric entry field]	
    • C_Q5A. How many comparison or control group participants overall are eligible to complete your first local evaluation survey? [Numeric entry field]	
    • C_Q5B. How many comparison or control group participants overall have completed your first local evaluation survey? [Numeric entry field]
Wave 2 (e.g., exit survey)
    • C_Q6A. How many treatment group participants overall are eligible to complete your second local evaluation survey? [Numeric entry field]
    • C_Q6B. How many treatment group participants overall have completed your second local evaluation survey? [Numeric entry field]
    • C_Q7A. How many comparison or control group participants overall are eligible to complete your second local evaluation survey? [Numeric entry field]
    • C_Q7B. How many comparison or control group participants overall have completed your second local evaluation survey? [Numeric entry field]
Wave 3 (e.g., 6-month follow-up survey)
    • C_Q8. Does your impact evaluation include a third survey (e.g., a follow-up survey after program exit)? [Selection field: Yes/No]
[If C_Q8 = No, skip to C_Q10]
    • C_Q8A. How many treatment group participants overall are eligible to complete your third local evaluation survey? [Numeric entry field]	
    • C_Q8B. How many treatment group participants overall have completed your third local evaluation survey? [Numeric entry field]	
    • C_Q9A. How many comparison or control group participants overall are eligible to complete your third local evaluation survey? [Numeric entry field]	
    • C_Q9B. How many comparison or control group participants overall have completed your third local evaluation survey? [Numeric entry field]	
Program/MIS records
    • C_Q10. Are you using program (e.g., MIS) records? [Selection field: Yes/No]
    • C_Q10A. [If C_Q10 = Yes] Are you receiving the program records (e.g., MIS data) you need for your evaluation on the schedule you need? [Selection field: Yes / No] 
[If A_Q5 = Qualitative]
Evaluations with qualitative data
    • C_Q11. Please select the qualitative data collection methods you are using. [Select all that apply]
        ◦ Staff interviews
        ◦ Participant interviews
        ◦ Staff focus groups
        ◦ Participant focus groups
        ◦ Observations
    • C_Q12. [If C_Q11 = Staff interviews] How many staff interviews have you completed to date? [Numeric entry field]
    • C_Q13. [If C_Q11 = Participant interviews] How many participant interviews have you completed to date? [Numeric entry field]
    • C_Q14. [If C_Q11 = Staff focus groups] How many staff focus groups have you completed to date? [Numeric entry field]
    • C_Q15. [If C_Q11 = Participant focus groups] How many participant focus groups have you completed to date? [Numeric entry field]
    • C_Q16. [If C_Q11 = Observations] How many observations have you completed to date? [Numeric entry field]




	
Section D. Conclusion
Last, we would like to ask about the overall progress of your evaluation and any support you may need.
Notes
    • D_Q1. Please enter any notes about the data reported above, including any concerns about data quality. [Text entry field]	
Progress
    • D_Q2. What is your assessment of overall evaluation progress? [Selection field: On track/Minor delays/Significant delays]
Support
    • D_Q3. Please describe any evaluation TA or support you need from your LETA team. [Text entry field]
Thank you for completing this form. Your LETA team will follow up with you to discuss your progress and any support needs.