Appendix A1. CFR Baseline Survey
Landing Page
Welcome to Fort Leonard Wood OSUT. Today, you will be completing the Individual Resilience Assessment (IRA). The IRA assesses life-skills that have been shown to help individuals manage and overcome stressful life events.
As part of your training, you are also being offered the opportunity to participate in a pilot evaluation for the Coaching for Resilience (CFR) program. The Department of Defense (DoD) has contracted NORC at the University of Chicago (NORC) to support an independent evaluation of the CFR program. NORC is a non-partisan, objective research institute that provides rigorous and reliable research and evaluation services to clients.
Participation in the evaluation involves a few extra survey questions (3-4 minutes) today beyond the mandatory Individual Resilience Assessment, a 15-minute follow-up survey in about four months, and an optional interview. The goal of this evaluation survey today is to understand what trainees learn as a result of participating in the CFR program and how that compares to people who do not participate in the program.
All Trainees from Platoons 1, 2, 3, and 4 who participate in the pilot evaluation today and complete the follow-up survey will receive a $15 e-gift card for the survey you complete today and a $30 e-gift card for the follow-up evaluation survey. Some soldiers will also be eligible for a $40 e-gift card for an interview.
Participation in the evaluation is voluntary. Trainees who do not wish to participate in the evaluation should select “no” and will be redirected to the mandatory Individual Resilience Assessment for Initial Entry Training.
Your contact information is stored separately from your survey responses. Responses to this survey are confidential and will not be shared with Army Performance Experts without your specific permission (at the end of this survey). Your responses will be combined with others, and the results will be reported to DoD and Army leadership in aggregate.
If you have any questions about this survey or the evaluation being conducted by NORC, please contact the NORC Project Team by email: ArmyResilience@norc.org.
OMB CONTROL NUMBER: 0704-0644
OMB EXPIRATION DATE: 01/31/2026
AGENCY DISCLOSURE NOTICE
The public reporting burden for this collection of information, 0704-0644, is estimated to average 18 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. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.
Privacy Advisory: Personal contact information is being collected and used by the NORC at the University of Chicago (NORC) for the purpose of distributing gift cards in thanks for your participation and to contact you for the follow-up CFR evaluation survey. Your information will be securely stored by NORC, will not be delivered to DoD for any non-stated purpose, and will be destroyed no later than September 28, 2027, at the conclusion of NORC’s contract. Providing your information is voluntary, however, choosing not to provide your personal contact information will result in NORC’s inability to offer the $15 gift card as a thank you for your participation today, and exclusion from the follow-up evaluation survey and the subsequent $30 gift card for participation in the follow-up evaluation survey.
Participation in the Coaching for Resilience evaluation is voluntary. Do you agree to participate in the pilot evaluation?
Yes, I agree to participate in the pilot evaluation. Trainees directed to demographics
No, I do not want to participate in the pilot evaluation. Trainees are redirected to IRA 2.0 survey.
DEMOGRAPHICS
What is your age?
17-25
26-35
What is the highest degree or level of school that you have completed? (Select one)
High school graduate (traditional diploma, GED, home school diploma, etc.)
Some college, but no degree
Associate’s Degree (e.g., AA, AS)
Bachelor’s Degree (e.g., BA, BS, AB)
Graduate or professional degree (e.g., MA, MS, Med, MBA, MSW, PhD, MD, JD)
What is your sex?
Female
Male
What is your race and/or ethnicity? Select all that apply and enter additional details in the spaces below. The survey is programmed to automatically recode your response into only two categories, preventing anyone from identifying you based on your answer to this question. No one will see your original response.
Blackfeet Tribe of the Blackfeet Indian Reservation of Montana, Native Village of
Barrow lnupiat Traditional Government, Nome Eskimo Community, Aztec, Maya, etc.
□ Chinese □ Asian Indian □ Filipino
□ Vietnamese □ Korean □ Japanese
Enter, for example, Pakistani, Hmong, Afghan, etc.
Black or African American - Provide details below.
□ African American □ Jamaican □ Haitian
□ Nigerian □ Ethiopian □ Somali
Enter, for example, Trinidadian and Tobagonian, Ghanaian, Congolese, etc.
Hispanic or Latino - Provide details below.
□ Mexican □ Puerto Rican □ Salvadoran
□ Cuban □ Dominican □ Guatemalan
Enter, for example, Colombian, Honduran, Spaniard, etc.
Middle Eastern or North African - Provide details below.
□ Lebanese □ Iranian □ Egyptian
□ Syrian □ Iraqi □ Israeli
Enter, for example, Moroccan, Yemeni, Kurdish, etc.
Native Hawaiian or Pacific Islander - Provide details below.
□ Native Hawaiian □ Samoan □ Chamorro
□ Tongan □ Fijian □ Marshallese
Enter, for example, Chuukese, Palauan, Tahitian, etc.
White - Provide details below.
□ English □ German □ Irish
□ Italian □ Polish □ Scottish
Enter, for example, French, Swedish, Norwegian, etc.
Additional Constructs for CFR Pilot Evaluation
Welcome to the Coaching for Resilience pilot evaluation.
Please answer the following questions.
SELF-AWARENESS/CONFIDENCE
Self-Efficacy
How strongly do you agree or disagree with these statements: |
Strongly Disagree |
Disagree |
Agree |
Strongly Agree |
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Help-Seeking Behaviors
Imagine that you begin to experience some problem. The problem is not so overwhelming that you can’t function. However, it continues for more than a few days. You consider seeking help from someone. Below are several reasons why you might choose NOT to seek help. Please read each reason and decide how important it would be in keeping you from seeking help.
How strongly do you agree or disagree with these statements: |
Strongly Disagree |
Disagree |
Agree |
Strongly Agree |
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Help-Seeking Attitudes
How strongly do you agree or disagree with these statements: |
Strongly Disagree |
Disagree |
Agree |
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Retention to the Military
How strongly do you agree or disagree with these statements: |
Strongly Disagree |
Disagree |
Agree |
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How strongly do you agree or disagree with these statements: |
Strongly Disagree |
Disagree |
Agree |
Strongly Agree |
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HEALTH STATUS
Mental Health
How much of the time, during the last month, have you |
All of the time |
Most of the time |
A good bit of the time |
Some of the time |
A little of the time |
None of the time |
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Initial Entry Training – Individual Resilience Assessment
This section of the survey is required for all initial entry Trainees, regardless of their participation in the Coaching for Resilience evaluation.
Please answer the following questions.
11. Coping Skills
Listed below are some strategies for coping with stressful situations.
Please rate how often you use the following strategies when coping with stressful situations: |
Never |
Almost never |
Sometimes |
Fairly often |
Very often |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
For questions 1, 2, and 3, please select the three coping strategies you use most often to cope with stressful situations. Please select the FIRST most often used strategy, then the SECOND, and finally, the THIRD most often used strategy for coping successfully with a stressful situation. Mark only one for each.
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a |
b |
c |
d |
e |
f |
g |
h |
i |
j |
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O |
O |
O |
O |
O |
O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
O |
O |
O |
O |
O |
Please indicate the extent to which the following statements describe you: |
Not at all |
Slight extent |
Moderate extent |
Great extent |
Very great extent |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
In the last month, how often have you... |
Never |
Almost never |
Sometimes |
Fairly often |
Very often |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
Please indicate how much you agree or disagree with the following statements: |
Strongly disagree |
Disagree |
Neither agree nor disagree |
Agree |
Strongly agree |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
Please indicate the extent to which you agree or disagree with the following statements about your current military life: |
Strongly disagree |
Disagree |
Neither agree nor disagree |
Agree |
Strongly Agree |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
Please rate how often you use the following strategies when dealing with a conflict: |
Never |
Almost never |
Sometimes |
Fairly often |
Very often |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
Please indicate the extent to which the following statements describe you: |
Not at all |
Slight extent |
Moderate extent |
Great extent |
Very great extent |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
Please indicate the extent to which the following statements describe you: |
Not at all |
Slight extent |
Moderate extent |
Great extent |
Very great extent |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
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O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
Please indicate the extent to which the following statements describe you: |
Not at all |
Slight extent |
Moderate extent |
Great extent |
Very great extent |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
Please indicate the extent to which the following statements describe you: |
Not at all |
Slight extent |
Moderate extent |
Great extent |
Very great extent |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
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O |
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O |
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O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
20. Social Determinants of Health
Regarding your life prior to entering the military, please indicate how much you agree or disagree with the following statements: |
Strongly disagree |
Disagree |
Neither agree nor disagree |
Agree |
Strongly agree |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
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O |
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O |
O |
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O |
O |
O |
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O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
Flag for Trainees Designated to Participate in Coaching Sessions
Which platoon are you assigned to?
1
2
3
4
For Platoon 1 or 2 trainees (will receive coaching):
Over the next few weeks, you will be receiving one-on-one coaching with Performance Experts as part of the Coaching for Resilience program. The Coaching for Resilience program is designed to (1) develop the life skills assessed by the IRA, (2) better prepare you for challenges in your personal and professional life, and (3) improve readiness and performance.
If you’d like to share your IRA results with the Performance Expert to customize your coaching sessions, please check “yes” below. If you are not interested in coaching, please check “no.”
___ Yes, I want to share my IRA results with the performance expert.
___ No, I do not want to share my IRA results with the performance expert.
For Platoon 1 or 2 trainees who opt into sharing IRA results with PEs & evaluation:
Please provide your name for the Performance Expert, for customized coaching, and for NORC to reach out to you about the follow-up evaluation survey in about 4 months. Your name will not be used for any non-stated purpose or linked to your survey responses in the final program evaluation reports to DoD.
First name: _______________________________
Middle initial: _______________________________
Last name: _______________________________
Click NEXT to wrap-up survey to be able to get your $15 thank you gift code from NORC!
For Platoon 1 or 2 trainees who opt into sharing IRA results with PEs, but do not opt into evaluation:
Please provide your name for the Performance Expert for customized coaching. NORC will only provide your name to the Performance Expert office for your customized coaching.
First name: _______________________________
Middle initial: _______________________________
Last name: _______________________________
Click NEXT to wrap-up survey to be able to get your $15 thank you gift code from NORC!
For Platoon 1 or 2 trainees who do not opt into sharing IRA results with PEs, but opt into evaluation:
Please provide your name. Your name will not be linked with any of your survey answers or used for any non-stated purpose. Your name will not be shared with anyone in your Army unit or chain of command or in the DoD. NORC will only use your name to reach out to you about the follow-up evaluation survey in about 4 months.
First name: _______________________________
Middle initial: _______________________________
Last name: _______________________________
Click NEXT to wrap-up survey to be able to get your $15 thank you gift code from NORC!
For Platoon 3 or 4 trainees (will not receive coaching):
For Platoon 3 or 4 trainees who opt into evaluation:
Please provide your name. Your name will not be linked with any of your survey answers or used for any non-stated purpose. Your name will not be shared with anyone in your Army unit or chain of command or in the DoD. NORC will only use your name to reach out to you about the follow-up evaluation survey in about 4 months.
First name: _______________________________
Middle initial: _______________________________
Last name: _______________________________
Click NEXT to wrap-up survey to be able to get your $15 thank you gift code from NORC!
CONTACT INFORMATION PAGE and THANK YOU PAGE
Thank you for completing the survey
We would like to confirm your contact information to send your $15 digital gift card and the follow-up evaluation survey. As a reminder, you will be eligible to receive an additional $30 digital gift card if you complete the follow-up survey in about 4 months. Your contact information will not be linked with any of your survey answers or used for any non-stated purpose. Your contact information will not be shared with anyone in your Army unit or chain of command or in the DoD. NORC will solely use this information for the communications about this evaluation effort.
What is your personal email address?
_______________________________
To allow NORC to text you with a reminder about the follow-up survey, please enter your cell phone number below:
What is your cell phone number? ___________
By providing this number, you allow NORC to text you using an automated text system. We will only use your phone number for the follow-up evaluation survey. NORC will not share, sell, or otherwise use this number. You can reply STOP to our text messages to opt out at any time. Reply HELP for help. Standard messaging and data rates may apply. Messaging frequency may vary.
End screen for trainees who opted into the evaluation
Thank you for participating in the evaluation of the Coaching for Resilience program!
Please look for an email from ArmyResilience@norc.org with a link to complete the follow-up evaluation survey in about four months.
If you have any questions, please contact NORC at ArmyResilience@norc.org.
End screen for trainees who did not opt into the evaluation
Thank you for completing the Individual Resilience Assessment (IRA) for Initial Entry Training.
ETAC T1 CFR
Evaluation
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Shagun Patel |
| File Modified | 0000-00-00 |
| File Created | 2026-01-07 |