New Community Technical Assistance Visit Quality Improvement Feedback Form (Onondaga) |
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Purpose:
This form solicits your feedback on the planning, implementation, and follow-up of the New Community Technical Assistance (TA) Visit. The Technical Assistance Partnership for Child and Family Mental Health (TA Partnership) will use this information to examine the current visit planning process, purpose, and procedures and recommend changes to enhance the effectiveness and efficiency of this activity.
Directions:
Please respond to the questions openly and honestly to provide information about activities that went well during your New Community TA Visit and activities that could be improved. We are asking the principal investigator, project director, TA coordinator, clinical director, family lead, youth coordinator, cultural and linguistic competence coordinator, social marketer, and evaluator from each community (if these roles exist in the community) to complete the form. If you are the community’s principal investigator or project director, we encourage you to ask these staff members to complete this feedback form.
Conditions of Confidentiality:
Your completion of this feedback form is voluntary and the TA Partnership will protect your identity to the extent possible. Only a handful of staff of the TA Partnership will have access to your individual responses – any TA Partnership staff who participated on this visit will not have access to individual responses. The TA Partnership will summarize the responses for your site and revise any recommendations and comments that may reveal the identities of respondents. The TA Partnership will send an aggregate summary of the results (not individual survey responses) to the New Community TA Visit Team, and TA Partnership senior management. We appreciate your time and effort providing this needed and valuable feedback.
For more information about this feedback form, you may contact Ivonn Ellis-Wiggan of the TA Partnership at 202.652.2390 or ielliswiggan@ffcmh.org. If you have concerns or questions about your rights as a participant in this activity, you can contact the American Institute for Research’s Institutional Review Board (which is responsible for the protection of project participants) by email at IRB@air.org, or by phone toll free at 1-800-634-0797 or mail c/o IRB, 1000 Thomas Jefferson Street, NW, Washington, DC 20007.
This form solicits your feedback on the planning, implementation, and follow-up of the New Community Technical Assistance (TA) Visit. The Technical Assistance Partnership for Child and Family Mental Health (TA Partnership) will use this information to examine the current visit planning process, purpose, and procedures and recommend changes to enhance the effectiveness and efficiency of this activity.
Directions:
Please respond to the questions openly and honestly to provide information about activities that went well during your New Community TA Visit and activities that could be improved. We are asking the principal investigator, project director, TA coordinator, clinical director, family lead, youth coordinator, cultural and linguistic competence coordinator, social marketer, and evaluator from each community (if these roles exist in the community) to complete the form. If you are the community’s principal investigator or project director, we encourage you to ask these staff members to complete this feedback form.
Conditions of Confidentiality:
Your completion of this feedback form is voluntary and the TA Partnership will protect your identity to the extent possible. Only a handful of staff of the TA Partnership will have access to your individual responses – any TA Partnership staff who participated on this visit will not have access to individual responses. The TA Partnership will summarize the responses for your site and revise any recommendations and comments that may reveal the identities of respondents. The TA Partnership will send an aggregate summary of the results (not individual survey responses) to the New Community TA Visit Team, and TA Partnership senior management. We appreciate your time and effort providing this needed and valuable feedback.
For more information about this feedback form, you may contact Ivonn Ellis-Wiggan of the TA Partnership at 202.652.2390 or ielliswiggan@ffcmh.org. If you have concerns or questions about your rights as a participant in this activity, you can contact the American Institute for Research’s Institutional Review Board (which is responsible for the protection of project participants) by email at IRB@air.org, or by phone toll free at 1-800-634-0797 or mail c/o IRB, 1000 Thomas Jefferson Street, NW, Washington, DC 20007.