Milestone Tracker App Provider Survey (English)

Approved form

OMB No. XXXX-XXXX

Expiration Date: XX/XX/XXXX

We want your feedback to improve this app for professionals!

This short survey will take about 5 minutes to complete. Your responses are anonymous and you may exit the survey at any time. The purpose of this survey is to help us better understand how the app is being used and if users are satisfied. Thank you for your time.

In what role do you most often use the Milestone Early Head Start/Head Start provider Tracker app? Early Educator or Teacher

WIC provider Home Visitor

Healthcare professional Other

Please describe your role

How do you usually use the Milestone Tracker app? Select all that apply.

Show families how to use the app

Show families features of the app (e.g., milestone checklists)

Review milestone checklists families have completed and/or the milestone summary

Ask families to complete a checklist using the app Use the app to track individual children (e.g., in my care or classroom)

Do not use the app, but distribute materials to promote it (e.g., app flyer)

Do not use or do not plan to use Other

Please share more about why you do not use or do not plan to use the app.

Please describe other times you typically use the Milestone Tracker app.

In general, how often do you use the Milestone Tracker Daily app with families and children under your care? Weekly

Monthly Yearly

A few times a year (3-5 times) Other

Please share more about how often you use the app.

Public reporting burden of this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing 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. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; Attn: OMB-PRA (0920-New)

Strongly Agree Agree Disagree Strongly Disagree

^{I like using this app.}

^{I like sharing this app with} families.

^{I can trust this app to help me} identify developmental concerns

and/or missed milestones in the children I work with.

^{This app helps me talk about} child development with families.

^{This app helps me share} concerns about a child's

development and/or missed milestones with families and/or other providers/professionals.

Which best describes most families that you typically work with? Select all that apply.

Low income Middle income Upper income

Which best describes the setting that you typically work in? Select all that apply.

Rural Urban Suburban

Did the Milestone Tracker app help you identify Yes

developmental concerns or missed milestones for any No children in your program/practice?

When you have identified developmental concerns or missed milestones using the app, what actions did you typically take? Select all that apply.

Shared your concerns with the family.

Performed or referred families for developmental screening.

Referred families to their healthcare provider. Referred families to intervention services/therapy (e.g., private therapy, state/county Early Intervention programs, school district).

Recommend that families wait to see if the concerns resolve over time.

I did not take any actions. Other

Please share more about why you did not take any actions.

Please share more about the other actions you took.

Do you plan to use the Milestone Tracker app to track Yes

child development in the future? No

Have you recommended this app for families to track Yes

their child's development? No

Have you recommended this app to other Yes

providers/professionals to track children's No development?

What State/Territory are you located in? Alabama (AL) Alaska (AK) Arizona (AZ) Arkansas (AR) California (CA) Colorado (CO) Connecticut (CT) Delaware (DE)

District of Columbia (DC) Florida (FL)

Georgia (GA) Hawaii (HI) Idaho (ID) Illinois (IL) Indiana (IN) Iowa (IA) Kansas (KS) Kentucky (KY) Louisiana (LA) Maine (ME) Maryland (MD)

Massachusetts (MA) Michigan (MI) Minnesota (MN) Mississippi (MS) Missouri (MO) Montana (MT) Nebraska (NE) Nevada (NV)

New Hampshire (NH) New Jersey (NJ)

New Mexico (NM) New York (NY) North Carolina (NC) North Dakota (ND) Ohio (OH) Oklahoma (OK) Oregon (OR) Pennsylvania (PA) Rhode Island (RI) South Carolina (SC) South Dakota (SD) Tennessee (TN) Texas (TX)

Utah (UT) Vermont (VT) Virginia (VA) Washington (WA) West Virginia (WV) Wisconsin (WI) Wyoming (WY)

American Samoa (AS) Guam (GU)

Northern Mariana Islands (MP) Puerto Rico (PR)

Virgin Islands (VI)

What ethnicity do you identify with? Hispanic/Latino

Not Hispanic/Latino

What race do you identify with? Select all that apply.

America Indian or Alaska Native Asian

Black or African American

Native Hawaiian or Other Pacific Islander White

11/01/2022 9:40am

projectredcap.org