Form 1 Targeted Survey

THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) Public reporting burden for this 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 control number for this project is XXXX-XXXX. The control number expires on X/XX/XXXX.

Child Welfare Information Gateway’s Targeted Survey

Instructions for On-line Survey Development

Surveys will be customized for selected sections of the Child Welfare Information Gateway (CWIG) website. For each of these sections (e.g. National Adoption Month, Family Engagement Inventory, National Foster Care and Adoption Directory, etc.) a survey will be created in on-line survey software to gather feedback that can inform project planning. Given the changing nature and context of each website section, it is important to be able to get feedback from recipients without creating undue burden by answering excessive questions that only marginally apply. To address this, the survey will be tailored to the unique information needs of each section to ensure low burden while informing high quality content development and website design. When creating each on-line survey, content specialists and evaluators will use the required questions listed below and choose up to five context specific optional questions that can be added to the survey, as needed. This will allow for unique information needs to be met.

It is expected that each tailored survey will have no more than 14 questions, including 7 required questions and a maximum of 7 optional questions, with a burden of no more than 5 minutes.

Required Questions

1. Overall, how satisfied are you with your interaction with the [Insert Website Section]?

1. Very satisfied

1. Somewhat satisfied

2. Neither satisfied nor dissatisfied

3. Somewhat dissatisfied (Please explain.):__________________________________________

4. Very dissatisfied (Please explain.):_____________________________________________

2. Which of the following best describes your background or role?

1. Professional

2. Student

3. Relative/kinship caregiver

4. Foster youth (current or former)

5. Prospective adoptive parent

6. Foster/adoptive parent

7. Birth parent

8. Other (please describe):______________

3. Which of the following best describes your professional background?

1. Prevention/family support (within child welfare agency)

2. Prevention/family support (outside child welfare agency)

3. Child protective services

4. Foster care services

5. Adoption services

6. Youth services

7. Juvenile justice

8. Health/mental health

9. Substance use

10. Legal/courts

11. Researcher/evaluator/consultant

12. Early childhood educator (0–5yrs)

13. Teacher (K–12)

14. Professor/faculty (higher education)

15. Training specialist

16. Licensing specialist

17. Other (Please describe.): ___________

4. Which of the following best describes your workplace? (Select one.)

1. Local or county child welfare agency

2. State child welfare agency

3. Tribal child welfare agency/organization

4. Federal agency

5. Community-based/faith-based organization

6. National organization (e.g., nonprofit, advocacy)

7. Training and technical assistance service provider

8. Educational institution (early education, K–12, college, university)

9. Other (Please describe.): _________________________________________________

5. Which of the following best describes your position? (Select one.)

1. Frontline worker (e.g., caseworker, direct service worker)

2. Supervisor/manager

3. Director/administrator

4. Training Specialist

5. Other (Please describe.): _________________________________________________

6. How many years of service do you have in your current profession?

1. Less than 1 year

2. 1-5 years of service

3. 6-10 years of service

4. 11-15 years of service

5. 16+ years of experience

7. How useful are the information and resources available in/on the [Insert Website Section]?

1. Very useful (Please explain.): _________________________________________________

2. Useful (Please explain.): _________________________________________________

3. Somewhat useful (Please explain.):______________________________________________

4. Not useful (Please explain.): _________________________________________________

Optional Questions – choose up to 7

Customer Profiles (demographic, information needs, etc.)

1. Which of the following best describes why you are visiting [Insert Website Section]?

1. I am looking for information to help me in my work.

2. I am looking for information to help me with my education.

3. I am looking for information to help me with a personal situation.

2. Please select the role that is most relevant for the purpose of this visit to the [Insert Website Section]:

1. Parent (includes birth parent, adoptive parent, foster parent)

1. Legal guardian/relative (e.g., grandparents)

2. Adopted person

3. Foster youth (current or former)

4. Concerned person

5. Prospective adoptive/foster parent

6. Other (please describe):________________________________________________________

2a. If you are a parent, are you a(n):

1. Birth parent

2. Adoptive parent

3. Foster parent

3. What degree are you pursuing?

1. B.S.W.

2. M.S.W.

3. D.S.W.

4. Ph.D. (please indicate your fields of study): ______________________________________

5. None of the above

4. In which state/territory do you work?

[Insert picklist of states and territories]

5. In which state/territory do you live?

[Insert picklist of states and territories]

6. How many years, including this year, have you visited the [Insert Website Section]?

1. This is my first year

2. 2-4

3. 5-10

4. More than 10

7. How many times have you visited the [Insert Website Section]?

1. This is my first time.

2. Once before

3. A few times in the past year

4. At least monthly

8. Is this the first year you have visited the [Insert Website Section]?

1. Yes

2. No

3. Don't Know

9. Please describe why you are visiting the [Insert Website Section]. (Select all that apply)

1. To find resources and outreach tools that I can use topromote awareness of [Insert Website Section]

2. To find resources and information for my work

3. To find [Insert topic or content area]

4. To find [Insert topic or content area]

5. Other (Please describe.): _________________________________________________

10. What topics and types of information are you most interested in reading about in [Insert Resource]? (Check all that apply.)

1. [Insert topic/type of information]

2. [Insert topic/type of information]

3. [Insert topic/type of information]

4. [Insert topic/type of information]

5. [Insert topic/type of information]

6. Other (please describe): ________________

Dissemination/Outreach

11. How did you hear about the [Insert Website Section]?

1. Search engine (e.g. Google, Yahoo)

2. Social media (e.g. Facebook, Twitter)

3. Conference or presentation (If known, please describe)

4. Email from Information Gateway or Children's Bureau (If known, please describe)

5. Browsing Child Welfare Information Gateway’s website

6. Email from another organization (e.g. [Insert Name of Partner Organization) (If known, please describe)

7. Colleague or friend

8. Hardcopy publication

9. Podcast/webinar

10. Mobile app search

11. Other (Please explain.): _________________________________________________

12. Please indicate your level of agreement with the following items.

    	1-Strongly Disagree	2	3	4	5-Strongly Agree	Not Applicable
    Child Welfare Information Gateway outreach messages were clear about how I could access [Insert Name of Special Initiative] information and resources.	1	2	3	4	5
    Child Welfare Information Gateway outreach messages were clear about how the information and resources would benefit me.	1	2	3	4	5
    Child Welfare Information Gateway outreach messages were tailored for my information needs.	1	2	3	4	5
    I trust the information and resources on the [Insert Name of Special Initiative] website.	1	2	3	4	5

13. Please indicate your response to the following items.

    	1-Strongly Disagree	2	3	4	5-Strongly Agree
    My colleagues typically acknowledge or read what I forward to them.	1	2	3	4	5
    When I learn something new and forward it to my colleagues, they are typically receptive to it.	1	2	3	4	5
    My agency is supportive of using information and resources from the [Insert Website Section].	1	2	3	4	5

14. If you received information about [Insert Website Section] from CWIG, do you have any suggestions for ways we can improve our outreach and dissemination efforts to increase the number of visitors to the [Insert Website Section]? ____________________________________________________________________

Website Usability

15. On a scale of 1 (poor) to 5 (excellent), please rate the following regarding the [Insert Website Section] and provide an explanation for your ratings in the space provided.

	1-Poor	2	3 - Neutral	4	5-Excellent	Please provide an explanation for your rating in the space provided.
Ease of finding information on the [Insert Website Section]	1	2	3	4	5
Website organization	1	2	3	4	5
Appeal of the [Insert Website Section] design	1	2	3	4	5
Content that matches my needs	1	2	3	4	5
Quality of search tool	1	2	3	4	5

Outcomes

16. How have you previously used or intend to use information and resources from the [Insert Website Section] (Select all that apply)?

1. I have not used or intend to use the information and resources.

2. Provide support to adoptive parents

3. Provide support to children awaiting adoption

4. Help identify, recruit, and retain prospective adoptive families

5. Improve recruitment efforts for adoptive parents

6. Increase my knowledge or inform my attitudes about adoption

7. Support public awareness or advocacy efforts

8. Share in a formal training environment

9. Other (please describe):____________

17. How have you previously used or intend to use the information or resources you were looking for today? (Check all that apply.)

1. Class assignment

2. Research (e.g., dissertation, paper) (please describe): __________________________________________

3. Internship/Practicum (please describe): ______________________________________________________

4. Career information

5. Other (please describe): _________________________

18. The following resources and tools are available to help you and your organization/agency promote [Insert Name of Special Initiative]. For each tool, please indicate whether or not you and your organization/agency have used it or intend to use it to promote [Insert Name of Special Initiative]. (Select all that apply)

    	Tools you or your organization/agency have already used	Tools you or your organization/agency intend to use	Please describe how you or your organization/agency have already used or intend to use this tool in the space provided.
    [Insert resource/tool]
    [Insert resource/tool]
    [Insert resource/tool]
    [Insert resource/tool]
    [Insert resource/tool]
    [Insert resource/tool]
    [Insert resource/tool]

19. Did you access the [Insert Name of Resource/Tool]?

1. Yes

2. No

3. I don't remember

20. How useful was the [Insert Name of Resource/Tool]

1. ( ) Very useful (please explain):: _________________________________________________

2. ( ) Useful (please explain):: _________________________________________________

3. ( ) Somewhat useful (please explain):: _________________________________________________

4. ( ) Not useful (please explain):: _________________________________________________

21. Was [Insert Name of Resource/Tool] helpful? Why or why not?

22. (If yes to above question) Please tell us how you intend to use the [Insert Name of Resource/Tool] and provide any comments or suggestions.__________________________

23. How did you use or intend to use the resources offered on the [Insert Website Section]? (Select all that apply and please provide details)

1. Increase my knowledge or inform my attitudes

2. Share with families and/or clients

3. Share with professionals or colleagues

4. Support public awareness or advocacy efforts

5. Share in a formal training environment

6. Support practice improvement and/or sustain good practice

7. Implement, sustain, or improve programs (e.g., program management, logic model development, program evaluation)

8. Support policy change and/or sustain good policies

9. Conduct research or evaluation

10. Grant writing/fundraising

11. My own professional development

12. Personal use

13. Other (please describe):

24. This year’s theme for our [Insert Website Section] is “[Insert new theme]” and highlights [Insert topics]. Do you have suggestions for next year’s theme? 

25. How frequently do you read [Insert resource]?

1. I read the [insert resource] every month

2. I read the [insert resource] a few times a year

3. I read the [insert resource] less than once a year

4. I’ve never read the [insert resource] before

26. How frequently do you use [Insert resource]

1. This is my first time

2. ( ) More than once a week

3. ( ) 1 to 4 times a month

4. ( ) 1 to 4 times a year

5. ( ) Less than once a year

27. Thank you for your participation in this survey. We are planning to also conduct telephone focus groups on these same topics later this year. Would you be interested in participating in one of these discussions?

1. Yes

2. No (end survey)

28. [If interested in focus group participation]: Please provide your contact information below so we can reach out to you when focus groups are being scheduled. Your information will not be used for any other purpose, other than contacting you about these focus groups.

Name: _______________________

Organization/Affiliation: _________________________

Email: _________________________

Phone number: _________________________

General Questions about CWIG products and services

Now we have a few questions about Child Welfare Information Gateway, as a whole, and some of our electronic subscription services.

29. Have you ever used Child Welfare Information Gateway (CWIG) (e.g., ordered a publication, contacted an information specialist, used an electronic listserv or subscription service, spoke to CWIG staff or obtained CWIG publication at a conference, etc.)?

1. Yes

2. No

3. I’m not sure

30. Which of the following subscription services do you receive (Check all that apply)?

1. I am not registered for any subscription services.

2. Child Welfare Information Gateway E-lert!

3. Children’s Bureau Express (CBX)

4. Child Welfare In the News

5. Adoption Triad

6. Information Gateway Quick Links

7. My Child Welfare Librarian

8. I get e-mails from Child Welfare Information Gateway but I’m not sure if they are a subscription service.

9. I’m not sure.

10. Other (please describe):_______________________________

31. What format(s) do you prefer to receive child welfare information and resources? Please choose up to three responses.

1. Mobile phone applications

2. Pamphlets or short handouts

3. Journal articles

4. Online news articles

5. Videos

6. Virtual trainings

7. Conference presentations

8. Presentation slides (e.g. PPT)

9. Webinars

10. Guidebooks or toolkits

11. Online e-books

12. Technical reports or briefs

13. Infographics

14. Podcasts

15. Other (please describe):______________

32. What format (s) do you prefer for purposes of sharing child welfare information and resources with stakeholders? (e.g. families, private providers, etc.)?

1. Mobile phone applications

2. Pamphlets or short handouts

3. Journal articles

4. Online news articles

5. Videos

6. Virtual trainings

7. Conference presentations

8. Presentation slides (e.g. PPT)

9. Webinars

10. Guidebooks or toolkits

11. Online e-books

12. Technical reports or briefs

13. Infographics

14. Podcasts

15. Other (please describe):______________

33. Do you have any additional comments or suggestions about the [Insert Website Section] or Child Welfare Information Gateway’s other products and services?_____________________________________________________________________

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