Peer Support Program SDD/OH Program Managers 6 Month Evaluation

We appreciate your taking the time to complete this questionnaire. All responses will be kept confidential and names will not be identified in any report. Your answers will help us to decide the future directions for this project. Should you have any questions please call Lori Cofano at (775)781-1722. Thank you!

Question Title

* 1. Name:

Question Title

* 2. In which state program do you currently work?

Question Title

* 3. Date started in the Peer Support Program (month/year):

Question Title

* 4. Current Date:

Question Title

* 5. Name of mentor:

Question Title

* 6. How useful were the following materials in explaining the Peer Support Program and preparing you to work with your peer support mentor?

  Very Useful Moderately Useful Slightly Useful Not Useful
Welcome to Peer Program Letter
Suggested Contact List and Website Resources
Ten Essential Elements to Build Infrastructure and Capacity for SOHPs
Mentoring article

Question Title

* 7. Were you satisfied with the interaction you had with the ASTDD New Member Services/Peer Support
Program consultant (Lori Cofano)?

Question Title

* 8. How long were you on the job when you started the Peer Support Program?

Question Title

* 9. When do you consider the best time to start in the Peer Support Program?

Question Title

* 10. If you started the Peer Support Program more than three months after starting your position, were there any initial barriers on the state level that prevented you from participating in the program?

Question Title

* 11. Which methods did you use to communicate with your Peer Support mentor? (Check all that apply.)

Question Title

* 12. Which methods were most effective? (Check all that apply.)

Question Title

* 13. Based on your experience in your state, is there anything else that ASTDD Central Office could do to assist new state dental directors/OH program managers immediately upon their employment, in addition to the Peer Support Program?

Question Title

* 14. Which of the Ten Essential Public Health Services to Promote Oral Health did your mentor help you with that may lead to program improvements? (Check all that apply).

Question Title

* 15. Which of the Competencies Guiding Principles did your mentor help you with that might increase your
skills or those of your staff? (Check all that apply)

Question Title

* 16. Which of the Competency Domains did your mentor help you with that might increase your skills or those of your staff? (Check all that apply)

Question Title

* 17. As a result of the Peer Support Program, do you and your mentor intend to continue the Peer Support relationship beyond the initial 6 months?

Question Title

* 18. Were the information and resources shared by your mentor relevant to the goals/outcomes that you identified in your peer support plan?

Question Title

* 19. What benefits have you or your program gained as a result of your participation in the Peer Support Program?

Question Title

* 20. We would appreciate any other comments or suggestions for improving the program.

Thank you for completing the evaluation.

T