Form 1 Public Health AmeriCorps TTA Questions

Process and Implementation Evaluation of Public Health AmeriCorps: Technical Assistance and Member Training Needs Form

June 12, 2023

NOTIFICATION EMAIL WITH LINK TO COMPLETE THE FORM

Public Health AmeriCorps is seeking your input to assess challenges grantees face in implementing their program. Your responses on successes, challenges, and the type of training that will support Public Health AmeriCorps members succeed at their service site, and in the communities that they serve will be inform resources for member training as well as technical assistance support to grantees for fiscal year 2023. The completion of the form will take approximately 15 minutes to complete. JBS International, an independent research and evaluation firm, will administer, collect, and summarize your responses for Public Health AmeriCorps. This data collection is part of the evaluation to build a deeper understanding of the experiences of Public Health AmeriCorps partners to identify any gaps in grantee resources and program delivery to inform continuous improvement.

[LINK TO FORM HERE]

For more information, please contact JBS International at 800-207-0750 or email at PublicHealthAmeriCorpsEval@jbsinternational.com.

CONSENT:

We need your consent to participate. JBS will report responses in the aggregate and will not reveal the identity or the responses for any specific grantee or organization.  Your responses about your organization’s Public Health AmeriCorps grant will remain confidential. Participation  will not affect any decisions about your program. Completing the form will take approximately 10 minutes. You can withdraw your participation in the data collection activities at any time.

1. Do you agree to participate?

1. Yes, I agree [GO TO Q1]

2. No, I do not agree [END FORM]

1. What challenges has your organization faced with operating your Public Health AmeriCorps program? [150 words limit]

2. What successes has your program accomplished to-date that align with the key program goals of PHA? Specifically, please share successes related to impacts of the program on community beneficiaries and on members gaining insight into a public health career.  [150 words limit]

3. What type of training could AmeriCorps offer your Public Health AmeriCorps members to enhance their impact at their service site, and in the communities that they serve? [150 words limit]

4. Please share any lessons learned that your team has identified since operating your program. [150 words limit]

Thank you again for taking the time to provide insights on the implementation of your Public Health AmeriCorps grant.
The JBS evaluation team will only use your responses for research purposes. For purposes of tracking response will you confirm your organization’s contact information?

5a. Name of your organization ______________________________________

5b. Your First Name: _________________________________________________

5c. Your Last Name: _________________________________________________

5d. Your work Phone: _________________________________________________

5e. Your work Email: _________________________________________________